Provider Demographics
NPI:1770928400
Name:MOR, ALISHA E (MD)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:E
Last Name:MOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:E
Other - Last Name:MAULER; O'MALLEY; SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:812 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1128
Mailing Address - Country:US
Mailing Address - Phone:402-426-2182
Mailing Address - Fax:
Practice Address - Street 1:812 N 22ND ST
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-1128
Practice Address - Country:US
Practice Address - Phone:402-426-2182
Practice Address - Fax:402-426-4642
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-48859207Q00000X
NE27930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098638061Medicaid
FL106131800Medicaid